Hearing-impaired listeners commonly report feelings of anxiety, stress, and mental fatigue in response to communication demands in social settings. These concerns are typically documented using subjective reports and questionnaires. The goal of this project is to quantify the overall effort involved in speech perception as indicated by a physiological measure of stress. Preliminary studies indicate that heart rate variability, or the variability in timing between consecutive heart beats, can provide objective evidence of changes in effort required for understanding speech at various signal-to-noise ratios. This project will provide an objective measure of the effort required for hearing- impaired listeners to understand speech presented in noise in an unaided and aided condition. The outcomes will be compared to a cohort of age-matched, normal-hearing listeners. PUBLIC HEALTH RELEVANCE: Hearing-impaired listeners commonly report feelings of anxiety, stress, and mental fatigue in response to communication demands in social settings. These concerns are typically documented using subjective reports and questionnaires. The goal of this project is to provide an objective measure of the overall effort involved in speech perception as indicated by heart rate variability, a physiological measure of stress.